CHRISTIAN DANANTO (2022) KORELASI POSISI TIP CATHETER DOUBLE LUMEN TEMPORER VENA SUBCLAVIA DEXTRA DENGAN KEJADIAN RESIRKULASI AKSES HEMODIALISIS PADA PASIEN PENYAKIT GINJAL KRONIK STADIUM V. Other thesis, Universitas Airlangga.

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Abstract

Recirculation is the phenomenon of the return of dialysis blood to the systemic circulation which is not in full equilibrium, the concentration of solutes in the blood in the arterial route is lower than in the systemic circulation, this indicates that there has been mixing of the dialyzed blood with undialysed blood entering the dialyzer. Determining the optimal position of the central venous catheter tip is complex and controversial. Blood flow in the Right Atrium (RA) is more static than in the Superior Vena Cava (SVC), the rate of rotation and vortex of RA blood flow is higher, SVC blood flow is more laminar and RA blood flow is more rotational, so that when CDL tips in RA, already dialyzed from a hemodialysis machine (low urea level) which is flowed in through the proximal orifice via a venous cannula has a higher chance of being aspirated through the distal orifice than if the tip was placed in the SVC. This research is an analytic observational, cross-sectional data collection is taken with a total sampling that meets the inclusion and exclusion criteria. Each sample was evaluated for the position of the CDL tip through a chest X-ray, then measured the distance from the carina. Then the blood urea level was checked for predialysis and after undergoing hemodialysis for 30 minutes, Qb was lowered to zero and simultaneously samples of blood flow between arteries and veins were taken respectively. Amount of urea measured, access recirculation value was calculated using Percent recirculation = ([P - A] [P - V]) × 100%. Based on Linear Regrresion test on the CDL tip position data and recirculation access data, there is a significant correlation p = 0,000 (p < 0,05). Which is the deeper the tip position towards RA have the higher the recirculation value.

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